Structural and effective brain connectivity in focal epilepsy

Q4 Neuroscience
S.B. Jelsma , M. Zijlmans , I.B. Heijink , F.W.A. Hoefnagels , M. Raemaekers , W.M. Otte , N.E.C. van Klink , D. van Blooijs
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引用次数: 0

Abstract

Epilepsy surgery is usually based on the removal of a local epileptogenic zone. If epilepsy is considered a network disease, a network approach might be more suitable. Insight into patient-specific epileptic brain networks is necessary to establish network-based surgical strategies.
We included epilepsy surgery candidates who underwent diffusion-weighted imaging and intracranial EEG implantation with single pulse electrical stimulation (SPES, 0.2 Hz, 1–8 mA, 1 ms, monophasic stimuli) during presurgical evaluation. We reconstructed structural connectivity using fiber tractography taking intracranial electrodes as nodes. We reconstructed effective connectivity with SPES cortico-cortical evoked responses. We determined the inter-modal similarity between structural and effective connectivity with the Jaccard index, and compared network topologies using degree and betweenness centrality. We constructed a linear multilevel model to evaluate the relation between structural and effective connectivity at subject group level. The seizure onset zone nodes (SOZ), node proximity, and the volume of the electrode contact areas (VEA) were added to the model as possible predictors to accommodate for epilepsy and irregular spatial sampling.
We included 13 patients (five with electrocorticography, eight with stereo-EEG). The median Jaccard index was 0.25 (IQR: 0.20–0.29), which means there is a higher overlap than expected by chance (median expected Jaccard index = 0.1 (IQR: 0.07–0.17)) with a considerable amount of connections that did not overlap. The structural connectivity degree showed a significant positive correlation with the effective connectivity degree in 9/13 patients and at group level after accommodating for node proximity (β = 0.13, 95 %-CI = [0.04, 0.21], t(852) = 2.79, p = 0.0054). SOZ and VEA were no significant predictors for the correlation between structural and effective connectivity.
We showed a moderate overlap between non-invasive structural (measured with DWI) and invasive effective (measured with SPES) connectivity in epileptic brain networks. This overlap supports using non-invasively determined connectivity along with intracranial EEG to understand the epileptic brain. Future research needs to translate these findings towards network-based surgical strategies.
局灶性癫痫的结构和有效脑连通性
癫痫手术通常是基于局部癫痫区切除。如果癫痫被认为是一种网络疾病,网络方法可能更合适。深入了解患者特定的癫痫脑网络是建立基于网络的手术策略所必需的。我们纳入了术前评估时接受弥散加权成像和颅内脑电图植入单脉冲电刺激(SPES, 0.2 Hz, 1 - 8 mA, 1 ms,单相刺激)的癫痫手术患者。我们以颅内电极为节点,利用纤维束造影重建结构连通性。我们重建了SPES皮层-皮层诱发反应的有效连通性。我们用Jaccard指数确定了结构连接和有效连接之间的模式间相似性,并使用度和中间性中心性比较了网络拓扑。我们构建了一个线性多水平模型来评估结构连接和有效连接在受试者群体水平上的关系。癫痫发作区节点(SOZ)、节点接近度和电极接触区体积(VEA)被添加到模型中,作为可能的预测因子,以适应癫痫和不规则的空间采样。我们纳入了13例患者(5例皮质电图,8例立体脑电图)。Jaccard指数中位数为0.25 (IQR: 0.20-0.29),这意味着重叠程度高于偶然预期(预期Jaccard指数中位数= 0.1 (IQR: 0.07-0.17)),并且有相当数量的连接没有重叠。在9/13例患者和组水平上,考虑节点邻近性后,结构连通性与有效连通性呈显著正相关(β = 0.13, 95% -CI = [0.04, 0.21], t(852) = 2.79, p = 0.0054)。SOZ和VEA对结构连通性和有效连通性的相关性无显著预测作用。我们发现在癫痫脑网络中,非侵入性结构连接(DWI测量)和侵入性有效连接(SPES测量)之间存在中度重叠。这种重叠支持使用非侵入性确定连接以及颅内脑电图来了解癫痫大脑。未来的研究需要将这些发现转化为基于网络的手术策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neuroimage. Reports
Neuroimage. Reports Neuroscience (General)
CiteScore
1.90
自引率
0.00%
发文量
0
审稿时长
87 days
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